Hodgkin’s disease, also known as Hodgkin’s lymphoma, was first discovered as a cancer of the lymphatic system by a man named Thomas Hodgkin in 1832. Hodgkin’s lymphoma is a moderately rare disease. An estimate of nine-thousand people are diagnosed with Hodgkin’s disease every year in the United States, and out of the currently identified cancers, Hodgkin’s disease accounts for lower than one percent. Despite its rarity, approximately 80% of treated patients will be cured. What causes Hodgkin’s disease is not entirely known, but evidence has given rise to propositions involving viral infection, particularly of the Epstein-Barr virus. There are several noted risk factors that increase one’s chances of contracting Hodgkin’s disease. The pathophysiology …show more content…
Evidence has linked Hodgkin’s disease to the exposure of infectious viruses. A virus of the herpes family called Epstein-Barr virus (EBV) is the characteristic virus implicated in Hodgkin’s disease. The Epstein-Barr virus has been found in the cells of approximately thirty to fifty percent of patients who are diagnosed with Hodgkin’s disease, and the activation of EBV can be evident in patients even before Hodgkin’s emerges. Studies have also indicated a higher risk for Hodgkin’s disease in those who had previously contracted infectious mononucleosis (IM). Approximately 20-40% Hodgkin’s patients who had previously contracted IM were found to have the EBV in the cancerous tumor. The correlation between EBV and IM indicates that the combinative presence of EBV and IM might be a causative factor for few cases of Hodgkin’s lymphoma. However, neither the absence of IM or EBV precludes the diagnosis of Hodgkin’s, as there are cases of Hodgkin’s disease in which the Epstein-Barr virus is absent. The cause remains unknown for patients with Hodgkin’s disease who have not contracted the Epstein Barr virus, although contraction of a virus yet to be identified has been proposed. Furthermore, it has been suggested that genetics play a role in the cause of Hodgkin’s disease. Twin studies have indicated that in monozygotic twins, the unaffected twin has almost a 100% increased risk of having Hodgkin’s lymphoma. In dizygotic …show more content…
Under normal conditions, after Fas becomes activated, Fas-associated death domain (FADD), death-inducing signaling complex (DISC) and caspase-8 will be recruited to the cell that is to undergo apoptosis. Caspase-8 plays a significant role in triggering the cascade that leads to the cell’s death. A protein called c-FLIP can be recruited when Fas becomes activated. Recruitment of c-FLIP prevents caspase-8 from being attracted. In Hodgkin’s disease, it is believed that upregulated c-FLIP expression in HRS cells leads to decreases of caspase-8. The absence of caspase-8 inhibits apoptosis. Resistance to apoptosis is also implicated through the apoptotic pathway involving the mitochondria of HRS cells. Mitochondria release cytochrome c which activates caspases. Eventually, caspase 3 will be activated. Caspase-3 induces the apoptotic response. In Hodgkin’s disease, it is proposed that there is an upregulation of X-linked inhibitor of apoptosis (XIAP) which will bind to caspase-3, therefore preventing cell death through